Effective Treatment and Copd

Scientific literature review on COPD This review and analysis seeks to show comparisons between the long-acting effects of tiotropium versus ipratropium in the reduction of exacerbation risk and referrals related to COPD in COPD patients. The data in this study was acquired from the General Practice data base for research (GPRD). The study shows that patients subjected to tiotropium treatment suffered severe COPD compared to those treated with ipratropium (Griffin et al. 2008).

The review also focused on when that medication is administered and the accompanying concomitant application of the inhaler and nebulizer relative to the quality of life, efficacy and symptoms of the patient. A study in which COPD patients of over 50 of age were randomly placed in three groups, i.e. inhaler, nebulizer and concomitant treatment was done. St. George's Respiratory Questionnaire was used to assess quality of life.

The most significant improvements in the quality of life were noted in patients who used nebulizer therapy in the morning and at night with the use of an inhaler at mid-day (Tashkin et al. 2007). The review highlights the weaknesses of the studies identified and critiques the viability of its key conclusions. Introduction COPD, which is the shorthand for obstructive pulmonary disease is characterized by airflow obstruction that is often partially irreversible. It is a progressive condition linked to abnormal inflammatory lung reaction to noxious gases or particles.

One of the common causes of this eventuality is cigarette smoking (Tashkin et al. 2007). The condition is made worse by constant exacerbations that happen with heightened severity over time. Lung function is usually seriously compromised. Multi-disciplinary approach to dealing with COPD encourages pharmacotherapy and bronchodilation. Available data suggests that anticholinergics for long acting therapy may present better outcomes compared to those for short acting treatment (Griffin et al. 2008).

Comparisons of short acting anticholinergics therapy versus long acting anticholinergic therapy approaches in the current time are not available yet for patients with COPD. Thus, this study seeks to compare the efficacy of the short acting ipratropium with the long acting tiotropium bromide on the basis of the risk of exacerbations of COPD and hospital referrals related to COPD in patients diagnosed with the condition within the last 12 months (Griffin et al. 2008).

The review also seeks to establish the effect on the quality of life when COPD treatment is approached using a nebulizer compared to only an inhaler or the use of the nebulizer and inhaler concomitantly compared with using an inhaler alone to administer the same medicine (Tashkin et al. 2007). The Scientific Method In a study by Griffin and colleagues (2008), data was obtained from the UK General Practice Research Database.

Differences between tiotropium and ipratropium were analyzed on the basis of outcomes that emanate from COPD in a follow up period that lasted for 12 months. The period was chosen to allow for seasonal changes and enable the researchers to record significant measurable changes in outcomes of COPD and related conditions. Data from GPRD was extracted retrospectively (Griffin et al. 2008). 90 codes relating to COPD indications were reviewed by a specialist physician who deals with respiratory medicine.

The whole set of 320 product codes were also reviewed by either a qualified UK pharmacist or a physician practicing in the UK (Griffin et al. 2008). A study in which the primary variable outcome was the quality of life as measured by validated St. George's Respiratory Questionnaire (self administered) was conducted and completed at baseline at six weeks and 12 weeks (2007) time span by Tashkin et al.; there were three component sub scores derived. The three included activity, symptoms and effects.

It compared the impact of inhaler versus nebulizer effect on the quality of life and common efficacy points that are assessed (Tashkin et al. 2007). Results Presented 4193 patients in GPRD met the inclusion criteria. The patients that were subjected to COPD treatment with tiotropium exhibited more severe symptoms compared to the ones treated with ipratropium. 1222 patients treated with tiotropium and 633 with ipratropium/salbutamol were included in the concluding analysis. The rations showing the incidence rate were 0.57 for COPD-linked referrals and 0.74 for exacerbations (Griffin et al.

2008) One patient completed one post baseline assessment on average. Both groups attained significant improvements after being subjected to a nebulizer based on the symptoms on the questionnaire. The concomitant cohort showed statistically and clinically significant positive changes in the total score of questionnaire symptoms. The concomitant group still exhibited significant improvement in the sub-scores for symptoms. The groups however failed to show any change in peak flow. There was no notable difference among the groups.

The two groups on a nebulizer showed notable improvement in diary symptom scores over time, even though there were no significant differences between the groups (Tashkin et al. 2007). Limitations The inclusion of patients treated with tiotropium for over a year is a possible limitation. Thus, the findings may not apply to patients who have been on the treatment for less than that period of time. Moreover, GPRD data retrieval is restricted to the variables on the data base.

It would be erroneous to assume that prescriptions were filled or that there was adherence to prescriptions by patients. Lack of sufficient information on patient management in health facilities is yet another limitation of the GPRD (Griffin et al. 2008). There is a possibility of patient bias for nebulizer therapy; presupposing that it is more effective compared to using an inhaler alone.

The fact that there is only short acting anticholinergic solution bronchodilators and adrenergic were compared with the same group of short acting bronchodilators administered from a single meter dose inhaler is yet another limitation (Tashkin et al. 2007). Findings and Conclusions Comparison of the efficacy of the medications and their ability to mitigate exacerbations and hospitalization due to COPD is possible as a result of the data collected. The results suggest that patients put on tiotropium treatment exhibited more severe symptoms of COPD relative to the ones on ipratropium/salbutamol.

Further, it.